Utilization of hematopoietic stem cell transplantation for the treatment of multiple myeloma: a Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) consensus statement

Gonsalves, Wilson I.; Buadi, Francis K.; Ailawadhi, Sikander; Bergsagel, P. Leif; Khan, Atiya; Dingli, David; Dispenzieri, Angela; Fonseca, Rafaël; Hayman, S. R.; Kapoor, Prashant; Kourelis, Taxiarchis; Lacy, Martha Q.; Larsen, Jeremy T.; Muchtar, Eli; Reeder, Craig B.; Sher, Taimur; Stewart, A. Keith; Warsame, Rahma; Go, Ronald S.; Kyle, Robert A.; Leung, Nelson; Lin, Yi; Lust, John A.; Russell, Stephen J.; Zeldenrust, Stephen R.; Fonder, Amie; Hwa, Yi L.; Hobbs, Miriam; Mayo, Angela; Hogan, William J.; Rajkumar, S. Vincent; Kumar, Shaji; Gertz, Morie A.; Roy, Vivek

doi:10.1038/s41409-018-0264-8

Cited by 92 publications

(79 citation statements)

References 142 publications

(114 reference statements)

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“…Definitions of therapeutic approaches within this paradigm of long-term treatment are summarized in Table 1 4,5 . This paradigm is being increasingly followed, with safety profiles of newer drugs improving long-term treatment feasibility vs. older agents 2 . Various long-term approaches in newly diagnosed MM (NDMM) are discussed within current guidelines and recommendations 1,[6][7][8][9][10] . Consequently, and associated with benefits demonstrated in randomized clinical trials, long-term therapy is used extensively in routine clinical practice in some geographies.…”

Section: Introductionmentioning

confidence: 99%

Developments in continuous therapy and maintenance treatment approaches for patients with newly diagnosed multiple myeloma

et al. 2020

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The evolving paradigm of continuous therapy and maintenance treatment approaches in multiple myeloma (MM) offers prolonged disease control and improved outcomes compared to traditional fixed-duration approaches. Potential benefits of long-term strategies include sustained control of disease symptoms, as well as continued cytoreduction and clonal control, leading to unmeasurable residual disease and the possibility of transforming MM into a chronic or functionally curable condition. "Continuous therapy" commonly refers to administering a doublet or triplet regimen until disease progression, whereas maintenance approaches typically involve single-agent or doublet treatment following more intensive prior therapy with autologous stem cell transplant (ASCT) or doublet, triplet, or even quadruplet induction therapy. However, the requirements for agents and regimens within these contexts are similar: treatments must be tolerable for a prolonged period of time, should not be associated with cumulative or chronic toxicity, should not adversely affect patients' quality of life, should ideally be convenient with a minimal treatment burden for patients, and should not impact the feasibility or efficacy of subsequent treatment at relapse. Multiple agents have been and are being investigated as long-term options in the treatment of newly diagnosed MM (NDMM), including the immunomodulatory drugs lenalidomide and thalidomide, the proteasome inhibitors bortezomib, carfilzomib, and ixazomib, and the monoclonal antibodies daratumumab, elotuzumab, and isatuximab. Here we review the latest results with long-term therapy approaches in three different settings in NDMM: (1) maintenance treatment post ASCT; (2) continuous frontline therapy in nontransplant patients; (3) maintenance treatment post-frontline therapy in the nontransplant setting. We also discuss evidence from key phase 3 trials. Our review demonstrates how the paradigm of long-term treatment is increasingly well-established across NDMM treatment settings, potentially resulting in further improvements in patient outcomes, and highlights key clinical issues that will need to be addressed in order to provide optimal benefit.

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Section: Introductionmentioning

confidence: 99%

Developments in continuous therapy and maintenance treatment approaches for patients with newly diagnosed multiple myeloma

et al. 2020

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“…Low-risk patients derived the largest benefit [40]. Retrospective studies have also confirmed the efficacy and safety of salvage ASCT [41]. Furthermore, salvage ASCT may restore the integrity and function of the bone marrow and compensate for drug-related hematological toxicity [42].…”

Section: Salvage Repeating Of Asctmentioning

confidence: 93%

“…Taking into consideration that NDMM patients who achieved MRD negativity in the IFM 2009 trial showed similar OS rates irrespective of the administration of upfront ASCT [16], MRD status with salvage re-induction may guide the decision for proceeding to a salvage ASCT. Therefore, salvage ASCT should be considered among patients who have been in remission after the initial ASCT for at least 36 or 18 months with or without maintenance, respectively [41], especially those with favorable disease characteristics.…”

Section: Salvage Repeating Of Asctmentioning

confidence: 99%

Multiple myeloma: Role of autologous transplantation

Ntanasis‐Stathopoulos¹,

Gavriatopoulou²,

Kastritis

et al. 2020

Cancer Treatment Reviews

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“…At the same time, the concept of "double-hit" and "triple-hit" was proposed (defined as that: 2 or even 3 high-risk genetic abnormalities existence the same time.) [10,11]. Also, amount of clinic trials had confirmed its prognostic outcomes.…”

Section: Ivyspring International Publishermentioning

confidence: 94%

Prognostic Value and Efficacy Evaluation of Novel Drugs for Multiple Myeloma Patients with 1q21 Amplification (Amp1q21) Only: A Systematic Review of Randomized Controlled Trials

Liang¹,

Li²,

Li³

et al. 2020

J. Cancer

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Background: Multiple myeloma (MM) is a heterogeneous disease characterized by chromosomal translocation, deletion, and amplification in plasma cells, resulting in a huge heterogeneity in its outcomes. Of all these cytogenetic abnormalities, Amp1q21 is most commonly detected, which is always associated with significantly shorter progression-free survival (PFS) and overall survival (OS) than normal 1q copy number status. In the era of novel agents such as bortezomib, ixazomib, lenalidomide, a head-to-head comparison of all these agents is still absent, especially in the patients with Amp1q21 alone. So, aiming to explore the optimum therapy to the patients with Amp1q21 only, we conduct this study. Patients and Methods:We searched the PubMed, the Cochrane Library, PMC and the Embase databases, and we selected all the randomized controlled trials (RCTs) in English about MM with Amp1q21 up to April, 2019. A total of 72 papers were full screened and finally 2 literatures can be included in our study. Results: Of the two studies, the one is about IRd (ixazomib, lenalidomide, dexamethasone) vs. placebo-Rd (HR, 0.781; 95% CI, 0.492-1.240), another is about VAD (vincristine, adriamycin, dexamethasone) vs. PAD (bortezomib, adriamycin, dexamethasone) (3-year survival rate: 59% vs. 83%, p=0.016). Conclusion: From this review, MM patients with Amp1q21 may somewhat benefit from ixazomib but the evidence is still stuffless. What's more, a head-to-head comparison between ixazomib and other agents among MM patients with Amp1q21 is also absent. So, we sincerely expect this review can attract some attention for the therapy of this special part of patients. This study was registered in https://www.crd.york.ac.uk/prospero/#recordDetails.

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Utilization of hematopoietic stem cell transplantation for the treatment of multiple myeloma: a Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) consensus statement

Cited by 92 publications

References 142 publications

Developments in continuous therapy and maintenance treatment approaches for patients with newly diagnosed multiple myeloma

Developments in continuous therapy and maintenance treatment approaches for patients with newly diagnosed multiple myeloma

Multiple myeloma: Role of autologous transplantation

Prognostic Value and Efficacy Evaluation of Novel Drugs for Multiple Myeloma Patients with 1q21 Amplification (Amp1q21) Only: A Systematic Review of Randomized Controlled Trials

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